Provider Demographics
NPI:1912646365
Name:SUDHIREDDY, ARISHNA ASHLEEN
Entity Type:Individual
Prefix:MRS
First Name:ARISHNA
Middle Name:ASHLEEN
Last Name:SUDHIREDDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16086 NW ASHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-7672
Mailing Address - Country:US
Mailing Address - Phone:848-209-7290
Mailing Address - Fax:
Practice Address - Street 1:10315 NE TANASBOURNE DR
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-7836
Practice Address - Country:US
Practice Address - Phone:503-286-6868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH7098124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist